First Successful Cell Transplant Cures Diabetes

Iphtashu Fitz writes "A few months ago the 50th anniversary of the first organ transplant was celebrated. Over those 50 years surgeons have learned how to sucessfully transplant many organs and other body parts. Now it seems that Japanese surgeons have added yet another successful transplant to the list, having recently transplanted insulin-generating cells, known as Islets of Langerhans from a mother to her diabetic daughter. Three months after the surgery both mother and daughter appear to be completely healthy. Although the daughter no longer needs insulin she still needs to take powerful drugs to keep her immune system from rejecting the new cells. Researchers also still don't know if this procedure would work in many people with type 1 diabetes since in many of those cases their own immune system has destroyed their Islet cells."

Comments

Future of treatment?

[Bananatree3]

With the advent of this new treatment, maybe thousands of diabetics could have the ability to live insulin-injection free. Yes, they do have to take anti-rejection drugs, but it is no different then taking the drugs for an organ transplant. Even if this is only a prelude to a new, more permenent treatment, the possibilities of this doing good with this new treatment is huge.

Re:Future of treatment?

[DigiShaman]

FYI, I'm not diabetic. However, trading one method of maintainin health for another doesn't sound such a good idea. I assume diabetics just need to take shots. But with this new transplant, they run the risk of much more illnesses and being sick more often due to the anti-rejection drugs.

With the diabetic shots at least, you know what can happen. It's predictable. But with the anti-rejection drugs, you just opened up a world of shit for yourself in regards to a suppressed amune system.

Re:Future of treatment?

[Jjeff1]

The idea that a diabetic just takes shots is not true at all. My brother has type 1, he was initially misdiagnosed and he almost died. The shots are intended to counteract the sugar in the food you eat. Now if you should mess up somehow, and it does happen, you could be in trouble. Low blood sugar, possibly caused by too much insulin, can cause a sudden diabetic coma and a trip to the hospital. Additionally, your blood sugar is affected by your mood and sometimes by nothing at all. I've heard that teenage guys can suddenly have their blood sugar go nuts when a pretty girl walks by. Some diabetics can tell when their blood sugar feels off and begin treating themselves, but some cannot. Also, when a diabetic has very high or low blood sugar, it affects their brain and their ability to think clearly. In school, all his teachers knew that if he should feel funny, they had to send another student to escort him to the nurse; otherwise he could literally get lost along the way.

In any case, many diabetics do not monitor themselves properly. They allow their blood sugar to consistently run too high, which in the long term can cause kidney failure, foot amputation, blindness and a host of other problems. Even diabetics that do monitor their blood sugar properly risk these things.

My brother has had a much easier time since he switched from injections to an insulin pump. He still has to do the tests, but when you're out in public, a finger prick test can be done fairly privatly, while injected yourself in the stomach cannot. With the pump, he hits some buttons on it and he's done.

I'm not sure that the rejection pills would be better, since I don't really know much about them. But I do know that diabetes is not at all the "I just take a shot" most people think it is.

Re:Future of treatment?

[krgallagher]

" FYI, I'm not diabetic. However, trading one method of maintainin health for another doesn't sound such a good idea."

FYI, I am diabetic. Trading regular doses of a anti-rejection drugs for the constant maintenance of my blood sugar all day every day is a trade I would happily make. I realize that you are not diabetic and cannot really understand what it is like. Diabetes is not a diseas that you "treat" with periodic injections of insulin. Because your body cannot regulate your blood sugar you have to do it yourself with both diet and medication, all day, every day. The consequences of failure can be fatal. Even if you do a good job, diabetes will almost certainly reduce your lifespan by more than 10 years. The consequences of failure also include blindness, kidney failure, the loss of limbs and heart disease. Yes, it is a trade I would make.

Re:Future of treatment?

[DerekLyons]

FYI I am a diabetic. I would rather take the risk of this transplanet then

[snippage of potential complications of diabetes]

A endocrinologist told me that no matter how well you take care of yourself with this disease you will die of a complication(sparing a death by trauma).

Everyone dies of something, get over it.

That being said; immunosuppressive drugs have a goodly list of potential complications of their very own. They aren't a panacea.

My whole life is taking care of this disease it a constant struggle.

You won't be much better off under a regemin of immunosuppressive drugs. A mild case of food poisoning (more common than most people suspect) that would give the average person a day or two of the runs; could kill you. You can't get live virus immunizations; they could kill you. What would be a mild case of the flu (I.E. the infamous 24 hour bug) for most people; could kill you. If you ever need surgery, you have a much higher chance of post-operative infection. (Not to mention the potential complications of such infection are much worse.)

Awesome, but. . . .

[physicsphairy]

Personally, I think I would probably prefer taking insulin to a number of immuno-depressing drugs.

Still valuable research, no doubt.

Will the life quality be better or worse?

[ladybugfi]

So the woman is not taking insulin anymore, but she is taking immuno-suppressants.

This means she has switched from one type of life-long medication to another type of life-long medication. Is this really a change for the better?

Asians leading the way

[Anonymous Coward]

I tell you, we Americans need to get off our collective ass and start doing some medical research. In the next 10 years Asians will have cured cancer and AIDS while we're celebrating successful eyebrow surgery or something equally useless.

Re:Stem cells.

[barbazoo]

They will be rejected too, since most diabetes type 1 patients' immune system are programmed to destroy insulin producing cells.

Woohoo!!!

[Duncan3]

Amazing what your country can do when your government hasn't banned some science and forbidden the rest.

Me American. Thump bible. That cure all! Bush say so.

Re:Woohoo!!!

[John Seminal]

Amazing what your country can do when your government hasn't banned some science and forbidden the rest.

Me American. Thump bible. That cure all! Bush say so.

You can't seperate the ethical questions from the scientific ones. If you are pissed off at how society anwsers ethical questions, then offer something more insightful to the debate than"Me American. Thump Bible".

It is true in some instances a majority of the voters don't want scientific advancement at the cost of their moral values. Maybe stem cell research can save the lives of people with parkinsins disease. But does society want an added value to more aboritions "Hey, the dead baby was good for something after all, lets have more of them". Is a life a commodity?

Without ethics, it is possible we would have places where people would broker in body organs. Have an extra kidney? We're buying! The poorest would sell a kidney, and the richest would get his transplant. But we don't have that system because or values and ethics say it is wrong.

When it comes to any research, we have to identify how we will continue. To some it is oppressive, like when the FDA takes so long to approve a drug. To others it is needed caution.

So, how about explaining your position a little better? All I can tell from your original post is you seem to have anger toward the Bible and Bush.

Re:Woohoo!!!

[FidelCatsro]

1: abortions are legal and its the persons choise if they decide to have one and frankly it is not our place to force our morality on others (ethics dont define what you decide you want done to yourself , it defines how you act to others IMO)

2: if these abortions are going to hapen ,then would it not be better to get something usefull out of them,If you belive that they were living thinking beings (not the debate as to if that is true or not) and there is nothing(ethicaly or moraly) you can do to stop it taking place then why not get some good out of it .

The analogy you use of the FDA doing further research is specious ,they are performing tests to assure the medicine does not cause more damage than it prevents , blocking funding to stem cell research does nobody any good , the pro lifers still get irate about abortions ,The religious folks who like to get irate with science and find another area of research to attack , the people suffering from parkensons lose some more hope ,The pro stem research lobbyist get a bit irate . all in all the situation is throughly iratating.

Im not an american and my views on Bushs other presidential acts otherwise aside , This was a totaly stupid decision that seems to me a bit like book burning .
The research will continue , Your tax dollars are put to better use(?) are they , do you know what the funds got diverted to , i can hasten a guess that it is not back to you or another scientific field, Stem cell advances that will(possibly nothing is certain , but its fairly likely) save millions of lives will instead hapen much later and instead of being partial protected will be in the hands of a private company and it will end up costing you more in the end .

The grandparent may have phrased it in a way that offended you slightly ,but he is very much right , its a no win situation unless you count votes for political fiqures a win , as thats the only thing to come out of this

Re:Woohoo!!!

[10Ghz]

But does society want an added value to more aboritions "Hey, the dead baby was good for something after all, lets have more of them". Is a life a commodity?

I don't think anyone would become pregnant just so they could be harvested for cells. But if they did, what would be the harm? It's not "dead baby". It's a fetus. It might be only few clustered cells without any brain-functions. If those cells could be used to cure someone from a mortal disease, I fail to see what damage it does. Of course, abortion is a big thing for the people involved, but if they want to do it, who are we to say "no"?

Abortions will happen. Outlawing them wont make them go away. And since they will happen no matter what, you might as well figure out ways how they could benefit the society as a whole. Demonizing the doctors who do them as "baby-killers" or something accomplishes nothing. using the cells for cures of disease or research accomplishes quite alot.

If you really want to reduce the number of abortions, you should focus on educating people. No, "say no to sex!" or bible-thumbing is not the answer. Objective information about different birth-control methods and making them available would be a good start.

And like it or not, life is a commodity. It has been since the dawn of time. We have had prostitutes, slaves, mercenaries and even regural wage-slaves. We all sell our lives to some extent for money.

Re:First implemented in Canada

[qewl]

Not only has the idea been around, but it has actually been performed multiple times. This was the just the first islet transplant from a [keyword]living[/keyword] donor. While still a great scientific event, the poster has misled and over-hyped this story.

Read more

The Japanese case is the first to be performed successfully using cells from a living donor. Previous cases involved donors who had died or who used their own reprocessed cells, which are injected back into their body.

I wonder

[theufo]

Since insulin is a relatively small polypeptide, wouldn't it be easier on the patient to grow the beta-cells on substrate inside microspheres with pores of about 50 nm? If you make the spheres out of non-organic material, immune cells will neither attack them or move into them.

ASCII art:

/-o-\
/ i \ i
/ \
| csc |
o csc io c = beta cells
| csc | s = substrate (serum proteins)
o csc o o = pore
\ / i = insulin
o / i
\_o_/

The insulin and glucose can traverse the pores, but immune cells can't reach the beta cells.

Just some wild speculation and it probably isn't even practical. I'm just a biochemist.

1.: not new. 2.: anti-immune drugs - even worse

[DexterF]

First of all: the cell transplant genie has been out of the bottle for about 5 years. Last mentioned success at King Hill hospital.
This is no way new.

2.: more important: the knock out here is the anti-immune-drugs. being treated with this means: live in a sterile environment, no carpet, no plants in your room etc, having any tooth fillings removed/teeth replaced with ceramics (drilled into the jaw. yes drilled) or a denture. And so on.
Plus, a simple cold hits you like a hammer.
So you pay your so called "health" with sacrifying a much larger portion of quality of life than the diabetes had an impact on.

Re:Not in my experience

[Doctor Beavis]

The trials that I have heard of will be small pilot trials. One of the main components of these 'tolerance' trials is that there is a concerted effort to try to prospectively identify biomarkers that may be predictive of when people may no longer need immunosuppressives (or immunotherapeutics as not all medications used in transplantation are truly 'suppressive'). Only if the pilot trials suggest that there may be something will it be moved to larger, more definitive trials. Also, the trials will probably initially take place in islet transplantation for several reasons.

Probably the most important is that it would be ethical to try withdrawing immunosuppression in this population (in contrast to say, heart transplant recipients, who would die if their organ were rejected). In islet transplants, the worst case scenario is that you are back on insulin. It's also possible that you could become sensitized to additional antigens during the rejection process, which may make it harder if you need a kidney down the road.

It is certainly possible that some organs will end up being rejected, but if information can be gleaned from the process that improves the safety and efficacy of transplant regimens, I think it's a reasonable trade-off. Obviously, however, the informed consent process needs to be very carefully thought out and meticulously executed in a tolerance/drug withdrawal trial. The Immune Tolerance Network is a good resource.

Re:Cure worse than condition still?

[SWTP_OS9]

Or if type 2. Taking stuff to keep your blood sugars level reasionable. Which that stuff usually affect the kidneys over times. And still run the risk of anything with small blood vessels having problems.

Sounds like. With this. You are changine one problem for another. Drugs that supress the amune system on rejection have there own nightmare.

Be nice for a total cure of this problem for both type 1 & 2.

Re:Stem cells.

[halber_mensch]

So, if implanted Islets can be used to replace insulin producing cells, then ones grown from the patients own stem cells can too. And without rejection.

You're forgetting why a type 1 diabetic's islets are destroyed in the first place - a type 1 diabetic with no islets suffers from an autoimmune disorder in which their immune systems has targeted their natural islets. Regrowing islets from their own stems cells would just re-introduce islets that are already recognized as foreign material. The cure, I speculate, is hunged mostly on curing the autoimmune disorder. We've been able to transplant b-cells, pancreases, and now the islets. But the root cause for the disorder needs to be fixed before a transplant or islet regrowth can be successful in the long term.